Provider Demographics
NPI:1841231156
Name:VEAZEY, WILLIAM BURT (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BURT
Last Name:VEAZEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 63112
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28263-3112
Mailing Address - Country:US
Mailing Address - Phone:336-274-9617
Mailing Address - Fax:336-482-2177
Practice Address - Street 1:1331 N. ELM ST.
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-6304
Practice Address - Country:US
Practice Address - Phone:336-274-9617
Practice Address - Fax:336-482-2177
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC93008402085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC18336OtherPARTNERS
NC84881OtherBLUE CROSS BLUE SHIELD
NC300065903OtherRAILROAD MEDICARE
NC8984881Medicaid
NC1602092OtherUNITED HEALTHCARE
NC2210405OtherMEDICARE
NC70522OtherMEDCOST
NCG02126Medicare UPIN